Usually called the doctor. Or the caretaker.

One issue--with the list & with comments--is that in some ways hoarders-packrats-collectors is a continuum, and some of the same advice can help, but in other ways there's a sharp line, and good advice for some people with stuff problems could be bad for hoarders, as you say.

One reason I spoke up is this comment on my own LJ, which left me a bit sensitive. As I said in this comment, I do like the idea that someone else can get use out of the item. But we are both (1) putting a lot of effort into finding people or institutions who do want the stuff, and (2) definitely NOT using it as an excuse to keep stuff, but in boxes-to-be-gotten-rid-of. And we do recycle battered books no one would want.

The key to me seems to be whether getting rid of something "correctly" is a way of not getting rid of it at all. But even there, it's hard to tell where desire to actually hang on to the recycling ends and a battle between good intentions and limited energy begins. Even the second is a psych issue, but it's a totally different one, more the kind everyone has.